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John, you make some really good points! A lesson to all who have older wills or assume their children are going to get everything upon their death. Laws change and unless you update your estate planning documents, you could end up with devolvement of your estate in a way you don't intend.

Pivotal Nursing Home Suit Raises a Simple Question: Who Signed the Contract? www.nytimes.com/2016/02/22/business/dealbook/pivotal-nursing-home-suit-raises-a-simple-question-who-signed-the-contract.html?mwrsm=Email&_r=0

NY Times: Pivotal Nursing Home Suit Raises a Simple Question: Who Signed the Contract? www.nytimes.com/2016/02/22/business/dealbook/pivotal-nursing-home-suit-raises-a-simple-question-who-signed-the-contract.html?mwrsm=Email&_r=0

In the full example explained during the Alzheimer's Association presentation, we considered how Mrs. Rose has no Health Care Agent and no person to whom she had given authority under a Power of Attorney document to manage her assets. Protective services had to file a Petition for Temporary Guardianship to arrange for her nursing home admission. How could any permissible transfers be made if Mrs. Rose is not competent, and has no authorized legal Agent to make transfers? Answer: A Conservator, appointed in Probate Court, could Petition for approval of an estate plan to protect Mrs. Rose and transfer her assets, if they, and her doctors, are certain that Mrs. Rose will never be able to leave nursing home care to return home.

When you sit down to sign a nursing home admission agreement, you are not in a position to negotiate and arbitration agreement. There is often no “meeting of the minds” when someone enters a nursing home. Elder abuse remains an issue in America, and people can’t anticipate that it could happen to them during the time of transition and crisis. Nursing home patients are at a severe disadvantage in securing performance of the contract for long term care. Prohibiting forced arbitration does not end arbitration as a dispute resolution tool. The patient or their family could choose arbitration if there is a problem or dispute.

The Consumer Financial Protection Bureau is considering a prohibition on financial services firms from including mandatory arbitration clauses common in many consumer contracts (as mentioned in the video on nursing home arbitration agreements). A CFPB Report to Congress found that 75 percent of consumers didn’t know if they were bound by an arbitration agreement in their credit card contracts. www.consumerfinance.gov/reports/arbitration-study-report-to-congress-2015/ Wealth Management reports that the CFPB proposal it would not ban arbitration clauses outright but would require companies to provide customers with the opportunity to go to court. wealthmanagement.com/blog/cfpb-takes-arbitration-clauses

On July 16, 2015, the Centers for Medicare and Medicaid Services (CMS) proposed new regulation on Nursing Home Arbitration Agreements and hundreds of other nursing home procedures and practices. Reform of Requirements for Long-Term Care Facilities that are paid by Medicare and Medicaid were published in the Federal Register. The proposals include a rule on dispute resolution and binding arbitration agreements [Sec. 483.70(n)]. The government agency said: “We considered not proposing any requirements concerning binding arbitration agreements. We share stakeholders' concern that some nursing homes may be requiring residents to sign agreements for binding arbitration as a requirement for admission into the facility. In addition, if the nursing home is not requiring the agreement as a condition of admission, some facilities may be requesting the resident to sign the agreement without fully explaining the rights the resident is waiving and the consequences of that waiver. We have proposed specific requirements if a nursing home chooses to request that a resident sign an agreement for binding arbitration. These requirements include, among other things, that the nursing home must explain the agreement to the resident in a form and manner that he or she understands, and that the resident acknowledge that they understand the agreement. We have also proposed specific requirements for the agreement, including that admission to the facility cannot be contingent upon the resident signing the agreement, the agreement must be entered into voluntarily, and the arbitration must be conducted by a neutral arbitrator in a venue convenient to both parties." Other proposed rules revise nursing home visitation requirements to establish open visitation, similar to hospitals. Many of the proposed rules require procedures that nursing homes have already put into practice: Rules governing care reviews require that a member of the food and nutrition services staff, and a social worker participate in the interdisciplinary team that develops the comprehensive care plan. Discharge plans must have a summary of arrangements for the resident's follow up care and any post-discharge medical and non-medical services. Other proposed rules try again to end negative practices that have long plagued nursing homes, including the use of drugs as a way to manage resident behavior and staffing shortages. "Each resident's drug regimen must be free from unnecessary drugs." Any use of psychotropic drugs must be based on a comprehensive assessment of a resident, and residents cannot by "given these drugs unless the medication is necessary to treat a specific condition as diagnosed and documented in the clinical record." www.federalregister.gov/articles/2015/07/16/2015-17207/medicare-and-medicaid-programs-reform-of-requirements-for-long-term-care-facilities

In Massachusetts House bill H 2029 is scheduled for a public hearing on December 8, 2015. After that, the Public Health Committee has until March 16, 2016 to vote the bill out of Committee. Then the bill has to go through various other Committees and pass before the end of December 2016, before it would require hospitals in Massachusetts to give notice of observation status to patients. malegislature.gov/Bills/189/House/H2029

Congress has voted to require hospitals to tell Medicare patients when they are under observation care and have not been admitted to the hospital. When signed by the President, the law will require hospitals to provide written notification to patients 24 hours after receiving observation care, explaining that they have not been admitted to the hospital, the reasons why, and the potential financial implications. khn.org/news/congress-overwhelmingly-approves-bill-bolstering-medicare-patients-hospital-rights/?KHN%3A+Daily+Health+Policy+Report&_hsenc=p2ANqtz-_RQHlzSC5elLsMTz14YQymhp3mn4_NgNN-YlzqBLoFoH3wkz3y6KxWyAZkqsyovKSmy0czZoiYdfFK-5wHLLfVpqdonQ&_hsmi=20917830 masshealthhelp.com/html/medicare.html

Congressman Joe Courtney (D-CT) and Sen. Sherrod Brown (D-OH) reintroduced a bill (S.843/H.R. 1571) to end the labeling of hospital stays as under “observation.” By doing so, it would restore Medicare coverage of follow-on skilled nursing care for seniors who have a three- or more day stay in the hospital. Currently, seniors placed under “observation status” often face very significant out-of-pocket costs for necessary, doctor-prescribed care. NAELA is an active member of a coalition that supports passage of this legislation.